Conclusions
Overall, opening schools and keeping them open in the context of the
Sars-CoV-2 pandemic is theoretically possible, although behaviourally
challenging and unfeasible if educational facilities or testing services
are inadequate. Based on the data synthesized here, we can establish
that, contrary to other respiratory viruses, children are not the
primary targets of Sars-CoV-2 infection, transmission and disease, and
schools may avoid becoming infection hubs for them, their teachers, the
educational staffs and their households. It also appears that the second
wave of the Sars-CoV-2 virus spread in the WHO European region has been
unrelated to school re-opening. The pandemic exit strategy should
necessarily prioritize an increased vigilance towards signs of negative
health outcomes of the public health emergency on the younger
population. A redeployment of public resources in such a direction might
soon become necessary: the urgency may shift away from COVID-19 and
towards increased prevalence of non-communicable and mental health
disorders in the general population. We urge public health institutions
across the globe to continue planning rescue programs and school
restructuring in the near future to overcompensate for all that has been
lost now, to avoid the future blame of the increasingly labelledCovid generation for not having used today all the available
evidences to protect their long-term global health.
In conclusion, the clear benefits justifying the indiscriminate use of
school closures as first-resorts at times of intensified viral spread in
the community may increasingly no longer be current. Larger and longer
prospective studies with widespread screening and mechanistic genomic
tracing are now needed for risk stratification for all virus variants of
concern, in different socio-economic contexts, background demographics
and school designs. It is our duty to encourage investments in this type
of research and best-informed policymaking, and to discourage all
generalizations and unverified assumptions in politicized debates for
school closure or opening by the lay public.